Lupus & antiphospholipid syndrome
Higher mortality without increased end-stage kidney disease (ESKD) risk in late-onset systemic lupus erythematosus (SLE) with lupus nephritis (LN) versus early-onset SLE: a Latin American cohort
Authors' conclusion
Despite no significant difference in kidney survival, late-onset SLE with LN is characterized by higher comorbidity burden, slightly higher chronicity scores, worse intermediate renal decline, and higher mortality.
Study context
- Population
- Patients with biopsy-proven LN diagnosed 2011–2024 at a tertiary referral centre, Latin America
- Participants
- 428 patients
- Exposure
- Late-onset SLE vs early-onset SLE in LN
- Late-onset SLEn = 58
- Early-onset SLEn = 370reference
- Outcome
- Kidney survival (ESKD), all-cause mortality, doubling of serum creatinine and composite outcome (ESKD, creatinine doubling or death)
Methodological detailssingle-centre, Cox proportional hazards models, competing-risk analysis for ESKD, with death as a competing event
- Single-centre
- Cox proportional hazards models
- Competing-risk analysis for ESKD, with death as a competing event
Main finding
As reported in the abstract
- Kidney survival did not differ significantly between groups
Observational data: associations, not effects.
Further findings
All-cause mortality
P < 0.001
Creatinine doubling
P = 0.046
| Outcome | aHR (95% CI) | |
|---|---|---|
| Composite outcome (ESKD, creatinine doubling or death) | 1.58 (1.05–2.36) | |
| 0.512Adjusted hazard ratio (log scale) |
Predictors of ESKD and mortality (multivariable)
- Lower baseline eGFR, higher chronicity index and greater non-renal damage independently associated with ESKD and mortality
Original publication
Higher mortality without increased ESKD risk in late-onset SLE with LN versus early-onset SLE: a Latin American cohort. Rheumatology (Oxford). Published 7 August 2026. doi:10.
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